Evaluation of testicular spermatogenic function by ultrasound elastography in patients with varicocele-associated infertility.

OBJECTIVE To investigate the application of ultrasound elastography and color Doppler ultrasound in the evaluation of testicular spermatogenic function in patients with varicocele (VC) associated infertility. METHODS A total of 196 patients with VC-associated infertility treated in our hospital from January 2018 to January 2020 were included as the research subjects (VC group), and were classified into VC I group (66 cases), VC II group (60 cases), and VC III group (70 cases) according to the diameter of spermatic vein and the degree of reflux under ultrasound. 50 age-matched healthy subjects were included as the control group. Color ultrasound, ultrasound elastography and semen examination were performed on all patients. RESULTS Compared with control group, a lower left testicular volume in VC group and a lower right testicular volume in VC III group were observed, and the left testicular volume was inversely proportional to VC grade (all P<0.05). Statistically significant differences in sperm viability, sperm density, peak systolic velocity (PSV), and MEAN values were determined among the 4 groups by one-way ANOVA, and between two groups by the independent-samples t test (all P<0.05). Pearson correlation analysis revealed that sperm viability and sperm density had no correlation with PSV, resistive index (RI) and pulsatility index (PI) of the left testicular artery in VC group, but were negatively correlated with the MEAN values of the testis. CONCLUSION Ultrasound elastography can predict the semen quality in patients with VC-associated infertility. CLINICAL TRIAL REGISTRATION This study was registered with the registration No. ChiCTR2010189 (URL: http://www.chictr.org.cn/showproj.aspx?proj=2018XE057-3).